Evaluation of Drug-Related Problems among Medical Intensive Care Unit Patients; the Role of Clinical Pharmacist

The complex nature of care provided in the intensive care unit (ICU) usually expose critically ill patients to poly-medication which makes pharmacological treatment as a significant risk factor for the occurrence of drug-related problems (DRPs). The current study aimed to identify and quantify DRPs by the clinical pharmacist among medical ICU (MICU) patients. The prospective observational study was conducted for a period of 6 months (January-June 2019) in 10-beds MICU of a tertiary care academic hospital located in Bangalore, India. For evaluation of DRPs, daily prescribed medications, and overnight emergency medications were analyzed by the pharmacist. Identified DRPs were classified based on Pharmaceutical Care Network Europe. All detected DRPs were reported during the daily medical round to MICU physicians. A total of 153 patients met inclusion criteria and were monitored by the pharmacist. Ninety-nine (64.7%) patients were male, and 54 (35.3%) patients were female. The mean age of 51.8 ± 18.4 years with an average length of MICU stay 9.3 ± 3.8 days were observed. In the current study, overall 240 DRPs were identified. The most common types of DRPs were drug-drug interaction (69, 28.7%), guideline nonconformity (53, 22.1%), and drug dose too high (25, 10.4%). Antibiotics were the most common medication involved in DRPs. Clinical pharmacist received 80.4% acceptance at the time of interventions. The collaboration of clinical pharmacist with multidisciplinary MICU healthcare team is beneficial for identifying and reporting DRPs among critically ill patients